Last updated on May 1, 2022. Cyanocobalamin Injection, USP 1000 mcg/mL, NDC 0517-0031-25 1 mL Fill in a 2 mL Vial Boxes of 25, NDC 0517-0032-25 10 mL Multiple Dose Vial Boxes of 25, NDC 0517-0130-01 30 mL Multiple Dose Vial Boxes of 1. Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B12. Hydrochloric acid and/or sodium hydroxide may have . See also DOSAGE AND ADMINISTRATION section. Semaglutide does not take the place of insulin and is not effective in people with type 1 diabetes or for the treatment of diabetic ketoacidosis. In the . Gastrointestinal: Mild transient diarrhea, Dermatological: Itching; transitory exanthema, Miscellaneous: Feeling of swelling of entire body. Will Ozempichelp my patients lose weight? | Cyanocobalamin is the most widely used form of vitamin B12, and has hematopoietic activity apparently identical to that of the antianemia factor in purified liver extract. If vitamin B12 is lyophilized, such as in some . Most vitamin products maintain their integrity and freshness if kept tightly sealed and stored at room temperature. If this occurs, semaglutide should be discontinued and not restarted. Canada residents can call a provincial poison control center. If more than five days have passed, skip the missed dose and just administer the next dose on the regularly scheduled day. If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot. Chronic treatment should be with an oral B12 preparation. Do not store in the freezer or directly adjacent to the refrigerator cooling element. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. The average diet supplies about 5 to 15 mcg/day of vitamin B12 in a protein-bound form that is available for absorption after normal digestion. If you use this medicine with insulin, do not mix them into the same syringe. Antihistamines appear to compete with histamine for cell receptor sites on effector cells. The major portion is excreted within the first eight hours. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. Before using this medication, tell your doctor or pharmacist your medical history, especially of: low potassium blood levels (hypokalemia), gout, kidney disease, a certain blood disorder (polycythemia vera), a certain eye disease (Leber's disease), other vitamin/mineral deficiencies (especially folic acid and iron). The structural formula is represented below. 1 Sterile Isopropyl Alcohol 70% Prep Pad In Canada - Call your doctor for medical advice about side effects. Most vitamin B12 supplements do not need to be refrigerated. Benzyl Alcohol, 1.5%, is present as a preservative. Dodex Injection: Package Insert - Drugs.com Cardiovascular: Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. Kit Contains: 1 Cyanocobalamin Injection, USP 1,000 mcg/mL (1 mL) 15 In tabs, what does D, You can enable the custom request tool in your shops settings if you want to create a private, custom listing for your buyer. What Are the Health Benefits of Dried Plums & Pitted Prunes? Amounts of vitamin B12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women (4 mcg daily) should be consumed during lactation. US residents can call their local poison control center at 1-800-222-1222. Semaglutide Updated 12/2021. Vitamin B12 has nine health benefits, all of which are based on scientific evidence. Vitamin B-12 doesn't break downeven at the boiling point of waterfor several hours. Discuss the risks and benefits with your doctor. Absorbed vitamin B 12 is transported via specific B 12 binding proteins, transcobalamin I and II to the various tissues. Ozempic(pronounced Oh-ZEM-pick) is a once-weekly injection indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease. Bavla Road, Ta.- Sanand, Consult your pharmacist or local waste disposal company. Never mix insulin with semaglutide and never share your injection with another person. At room temperature, vitamin B-12 is stable. How To Store B12 Liquid? - Sublingual Vitamin B12 Learn about the safety profile for Ozempic. Here is what it says: Bragg Liquid Aminos does not need to be refrigerated, either before or after opening/using, as it has a 3 year shelf life. Privacy Policy Also available as a once-weekly prefilled injection pen that is given subcutaneously (under the skin) (Ozempic brand). Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTION), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Please click here for Ozempic Prescribing Information, including Boxed Warning. Ozempic is available in the following doses: The 0.25 mg dose is intended for treatment initiation and is not effective for glycemic control. The molecular weight is 1355.39. Offer is good for up to 24 months. 5 mg/kg/24 hr or 150 mg/m2/24 hr. The Ozempic 2-month and 3-month savings offers are intended to help patients minimize gaps in therapy. In rare cases, allergic reactions can happen with the injectable form of B-12. Maximum daily dosage is 300 mg. Divide into four doses, administered intravenously at a rate generally not exceeding 25 mg/min, or deep intramuscularly. The liver is the main organ for vitamin B 12 storage. Keep Neo- B12 Injection in a cool dry place, where the temperature stays below 25C. Check with your mobile service provider. Sterile Alcohol Prep Pad (Dynarex)* Basal insulin can be combined with either dose of once-weekly Ozempicand titrated as needed.1Review the A1C reductions of Ozempicin combination with basal insulin. We comply with the HONcode standard for trustworthy health information. Vitamin B12 helps your body use fat and carbohydrates for energy and make new protein. Medically reviewed by Carmen Fookes, BPharm. We are experiencing temporary supply constraints, which means some pharmacies may not have certain Ozempic dosages in stock. Rochester, MI 48307. Because of the high levels of omega-3, fish oil supplements can reduce cholesterol and possibly reduce inflammation. These include liquid vitamins, some essential fatty acids and probiotics. 2019 www.azcentral.com. It occurs as a white, crystalline powder, is freely soluble in water and alcohol and has a molecular weight of 291.82. Vitamin pills contain preservatives that increase their shelf life. The transition of the OzempicPen to a 3 mL pen allows all doses of Ozempic to be supplied in the same device with clear differentiation in pen packaging. Vitamin B-12 - Mayo Clinic Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Keep Neo-B12 Injection in a cool dry place, where the temperature stays below 25C. Atropine-like signs and symptoms; dry mouth; fixed, dilated pupils; flushing; and gastrointestinal symptoms may also occur. Flaxseed oil contains a high concentration of phyto-nutrients that are beneficial to human health, according to the National Center for Complementary and Alternative Medicine. Hydroxycobalamin is equally as effective as cyanocobalamin, and they share the cobalamin molecular structure. Cyanocobalamin appears as dark red crystals or as an amorphous or crystalline red powder. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment. Chronic treatment should be with an oral B 12 preparation. Diphenhydramine hydrochloride is widely distributed throughout the body, including the CNS. Antihistamines are also contraindicated in the following conditions: Hypersensitivity to diphenhydramine hydrochloride and other antihistamines of similar chemical structure. Do not freeze. Each mL contains 1000 mcg cyanocobalamin. If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Neurologic manifestations will not be prevented with folic acid, and if not treated with vitamin B 12, irreversible damage will result. Please see the Dosing & Prescribing page for other details about prescribing Ozempic in your EHR. STORE AT CONTROLLED ROOM TEMPERATURE Things to remember when you fill your prescription. | Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely. Ozempic, metformin, simvastatin, Xarelto, Trulicity, phentermine, Wegovy, Lantus, Victoza, Tresiba. Like fish oil, flaxseed oil is a good source of omega-3 essential fatty acid. Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy. Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B 12. This will, Copyright 2023 TipsFolder.com | Powered by Astra WordPress Theme. Selected from data included with permission and copyrighted by First Databank, Inc. Based on information from related drugs, this medication may pass into breast milk. A multi-dose vial is a vial of liquid medication intended for parenteral administration (injection or infusion) that contains more than one dose of medication. Cookie Policy Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Additional information. Most people get enough vitamin B12 in their diet, but a deficiency may occur in certain health conditions (such as poor nutrition, stomach/intestinal problems, infection, cancer). Semaglutide works by mimicking the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. US22OZM01108January 2023, Learn about the safety profile for Ozempic, A 0.25 mg starting dose and a maintenance dose of 0.5 mg, both available in a red-label pen, A maintenance dose of 1 mg available in a blue-label pen, A maximum maintenance dose of 2 mg available in a yellow-label pen, Contains 2 mg of semaglutide in a 3 mL (0.68 mg/mL) pen, Delivers doses of 0.25 mg or 0.5 mg per injection, Contains 8 mg of semaglutide in a 3 mL (2.68 mg/mL) pen, The most common adverse reactions, reported in 5% of patients treated with Ozempic, There are limited data with semaglutide use in pregnant women to inform a drug-associated risk for adverse developmental outcomes. Does Cyanocobalamin (Vit B-12) 1,000 Mcg/Ml Injection Solution interact with other drugs you are taking? Package insert / product label Cyanocobalamin is a man-made form of vitamin B12 used to treat low levels (deficiency) of this vitamin. Starting March 2023, the packaging has changed, however there will still be one pen per box. Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time. Store at controlled room temperature 1530C (5986F). Is there an Ozempic patient starter kit? Based in Jacksonville Beach, Fla., Laurie Dickinson began writing in 1977. Tell your doctor right away if any of these serious side effects occur: muscle cramps, weakness, irregular heartbeat. Gastrointestinal absorption of vitamin B 12 depends on the presence of sufficient intrinsic factor and calcium ions. Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Month is defined as 28 days. Sterile Towel Drape (Dynarex)*. https://www.drugs.com/monograph/semaglutide.html. Use these dosage charts for infants and children under 12 years old: Diphenhydramine hydrochloride is an antihistamine with anticholinergic (drying) and sedative side effects. Generally speaking, around 50 to 98% of the vitamin B12 taken is excreted from the body 48 hours after injection. Antihistamines should be used with considerable caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, symptomatic prostatic hypertrophy, or bladder-neck obstruction. Patients with pernicious anemia have about 3 times the incidence of carcinoma of the stomach as the general population, so appropriate tests for this condition should be carried out when indicated. Not considered as first-line therapy for type 2 diabetes. Instructions for using the pen can be foundhere. Manufactured for: Her articles have appeared in the fine-arts magazine "The Phoenix" and various online publications. Amounts of vitamin B 12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women (4 mcg daily) should be consumed during lactation. Do you need to refrigerate Braggs soy sauce? B-12 Compliance Injection Prescribing Information, Carcinogenesis, Mutagenesis, Impairment of Fertility, Pregnancy: Teratogenic Effects. Do not freeze). Speak to your doctor about how drug interactions should be managed. They have no major side effects. By this time hematologic values should have become normal. Carcinogenesis, Mutagenesis, Impairment of Fertility: Long term studies in animals to evaluate carcinogenic potential have not been done. Do not freeze). Medically reviewed by Drugs.com. Yes! Cyanocobalamin Injection, USP is also suitable for the vitamin B 12 absorption test ( Schilling test). Within 48 hours after injection of 100 or 1000 mcg of vitamin B 12, 50 to 98% of the injected dose may appear in the urine. ASSISTANCE OR CONTACT A POISON CONTROL An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. sterile, pyrogen-free solution containing 50 mg diphenhydramine hydrochloride in a 1-mL ampoule. Will the updated Ozempic Pen that delivers 0.25 mg and 0.5 mg doses affect cost and coverage? Benzyl Alcohol, 1.5%, is present as a preservative and Water for Injection q.s. Ozempicshould be protected fromexcessive heat and sunlight. Maker of Diet Drug Wegovy Ramps Up Production to Meet Demand, Ozempic: Dieters Who Use Scarce Diabetes Drug Could Face Side Effects. It doesn't need to be refrigerated. Vitamin B-12 is stable at room temperature. Cyanocobalamin Injection, USP is also suitable for the vitamin B12 absorption test (SCHILLING TEST). The multidose Steri-Vials contain 0.1 mg/mL benzethonium chloride as a germicidal agent. sterile, pyrogen-free solution containing 50 mg diphenhydramine hydrochloride in each milliliter of solution with 0.1 mg/mL benzethonium chloride as a germicidal agent. Can Ozempicbe used in combination with basal insulin? Benadryl (diphenhydramine hydrochloride) is an antihistamine drug having the chemical name 2- (Diphenylmethoxy)-N,N-dimethylethylamine hydrochloride. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Supplements in capsules have casings that protect them from oxidation and therefore do not need refrigeration. Vitamin B-12 is stable at room temperature. Swallow the tablets whole, do not cut, crush, or chew. The injection is given once a week, on the same day each week (for example, every Monday). Do not store this medicine or any other medicine in the bathroom or near a sink. Store at room temperature away from light and moisture. Semaglutide lowers blood sugar levels by mimicking the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. Cardiovascular: Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis. What is too much? If you need to store Neo-B12 Injection, keep it in the original pack until it is time for it to be given. Common side effects include low blood sugar levels, nausea, vomiting, and diarrhea. Cyanocobalamin injection is used to treat and prevent a lack of vitamin B 12 that may be caused by any of the following: pernicious anemia (lack of a natural substance needed to absorb vitamin B 12 from the intestine); certain diseases, infections, or medications that decrease the amount of vitamin B 12 absorbed from food; or a vegan diet (strict vegetarian diet that does not allow any animal . What Is the Function of Pepsin in Digestion? See how to prescribe a 1-month or 3-month supply of Ozempicin your EHR systemhere. Before using cyanocobalamin, tell your doctor or pharmacist if you are allergic to it; or to cobalt; or if you have any other allergies. How long does it take to complete Doom 2016? Overdose with this medication is very unlikely. If it is unopened, then it is good until the expiration date on the label. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. COMMON BRAND NAME (S): B-12 Compliance Kit, B-12 Injection Kit, Cyomin, Dodex, LA-12, Nutri-Twelve, Physicians EZ Use B-12 . The molecular weight is 1355.39. General Precautions: Vitamin B12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord. Dosage form: kit Gamma-Sterilized* Isopropyl Alcohol, 70% by Volume, Nitrile Powder Free Sterile Gloves (Dynarex) - Size 7.5* Do not freeze). Consult your doctor before breast-feeding. Store at 20-25C (68-77F); excursions permitted to 15-30C (59-86F) (See USP Controlled Room Temperature). Hydroxycobalamin is equally as effective as cyanocobalamin, and they share the cobalamin molecular structure. Antihistamines are more likely to cause dizziness, sedation, and hypotension in elderly patients. Repeat determinations of iron and folic acid may reveal a complicating illness that might inhibit the response of the marrow. The vitamin B12 will be absorbed by the surrounding muscle as soon as it is pushed through the needle. Failure to do so will result in return of the anemia and in development of incapacitating and irreversible damage to the nerves of the spinal cord. Package insert / product label The kit includes information on: Ozempic (semaglutide) injection 0.5 mg, 1 mg, or 2 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease. In each case, patients can then resume their regular once-weekly dosing schedule. Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Dosage is based on your medical condition and response to treatment. Do you have to refrigerate B12 injections? - WisdomAnswer View complete list of side effects. Each vial also contains Sodium Chloride, 0.9%. These should be stored at room temperature, away . Manufactured by: Intrinsic factor deficiency causes pernicious anemia, which may be associated with subacute combined degeneration of the spinal cord. In the young pediatric patient, particularly, they may produce excitation. Amounts of vitamin B12 that are recommended by the Food and Nutrition Patients following such a diet, should be advised to take oral vitamin B 12 regularly. Reduces the risk of future cardiovascular events, such as a heart attack or stroke, in people with type 2 diabetes who also have heart disease. Serious vitamin B12 deficiency may result in anemia, stomach problems, and nerve damage. Since liquid vitamins do not contain these additives they require refrigeration, according to DoctorYourself.com. aApplies to eligiblecommercially insured patientswith coverage for Ozempic. Once you have opened them, they are also exposed to oxygen and can spoil if left out of the refrigerator. : 457, 458, Village Matoda, Long-term studies in animals to determine mutagenic and carcinogenic potential have not been performed. Forms of probiotics include acidophilus and other live bacteria supplements, reports Harvard Health Publications. Self-administration of the prefilled pen injection is easy to learn for most people. Dodex Injectable (Cyanocobalamin Injection, USP 1,000 mcg/mL) is supplied as follows: NDC 16729-533-63 1 mL Multiple Dose Vial Boxes of 1, NDC 16729-533-08 1 mL Multiple Dose Vial Boxes of 25, NDC 16729-533-03 10 mL Multiple Dose Vial Boxes of 1, NDC 16729-533-10 30 mL Multiple Dose Vial Boxes of 1. Each vial also contains Sodium Chloride, 0.9%. This regimen should be followed by 100 mcg monthly for life. Patients can connect with a Diabetes Health Coach who can help answer questions about their prescription, diet, and exercise. Prompt parenteral administration of vitamin B12 prevents progression of neurologic damage. Check the liquid in the pen. Has not been adequately studied in pregnant women and should not be used unless the perceived benefits outweigh the risks of uncontrolled diabetes, which include preeclampsia, spontaneous abortions, and preterm delivery. The liver is the main organ for vitamin B12 storage. Folic acid should be administered concomitantly if needed. Cyanocobalamin Injection, USP is a sterile solution of cyanocobalamin for intramuscular or subcutaneous injection. Requirements of vitamin B12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation. Vitamin B-12 doesn't break downeven at the boiling point of waterfor several hours. Nursing Mothers: Vitamin B12 is known to be excreted in human milk. Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time. It is then transported by the transcobalamin binding proteins. Do not freeze Ozempicand do not use Ozempicif it has been frozen. Use with caution in patients with lower respiratory disease including asthma. The average diet supplies about 5 to 15 mcg/day of vitamin B 12 in a protein-bound form that is available for absorption after normal digestion. In the majority of cases, taking a B vitamin does not cause weight gain. This regimen should be followed by 100 mcg monthly for life. Novo Nordisk is a registered trademark of Novo Nordisk A/S. WARNING: KEEP THIS AND ALL MEDICATION Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B12. If it is a multidose vial and it is opened, it should be kept in the fridge and then discarded after 30 days though, no matter what the expiration date is. Miscellaneous anxiolytics, sedatives and hypnotics, Benadryl Dosage Charts (Infants & Children). All rights reserved. It is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) or diabetic . Drug/Laboratory Test Interactions: Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B12 diagnostic blood assays. If you miss your injection of semaglutide, administer it as soon as possible, but within 5 days of the missed dose. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Helium Filaments can also be awarded to, 13 As a result, how many levels does Doom 2016 come with? Antihistamines are also contraindicated in the following conditions: diphenhydramine hydrochloride injection, solution. 1 Sterile Adhesive Bandage, DISTRIBUTED BY: Talk to your pharmacist for more details. Vitamin B: During the canning process, most types of vitamin B are lost, but freezing traps the majority of complex vitamin B vitamins, such as niacin, riboflavin, biotin, folate, and B12. Administer Ozempiconce weekly on the same day each week, at any time of the day, with or without meals. B-12 Compliance Injection Description. It is also a great source of fiber and protein. May be given alone or in combination with other antidiabetic agents such as metformin, insulin, or a sulfonylurea. Keep the pen cap on when not in use. . Hematocrit and reticulocyte counts should be repeated daily from the fifth to seventh days of therapy and then frequently until the hematocrit is normal. Glacial acetic acid may has been added during manufacture to adjust the pH (range 4.5-7.0). Always consult your supplier if you have further questions regarding storage of your injectable B vitamin supplements. Medically reviewed by Drugs.com. Once you have opened them, they are also exposed to oxygen and can spoil if left out of the refrigerator. 4. We comply with the HONcode standard for trustworthy health information. This drug should not be used in neonates or premature infants. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Also, like fish oil, flaxseed oil can help reduce inflammation and cholesterol. | Storage. Cooking doesn't destroy it. Cyanocobalamin is quantitatively and rapidly absorbed from intramuscular and subcutaneous sites of injection; the plasma level of the compound reaches its peak within 1 hour after intramuscular injection. The bathroom might not be a good idea either, as the humidity caused by the shower might increase the room . If you have questions, please reach out to your local Novo Nordisk representative. Last updated on Sep 21, 2022. Benadryl should not be used in neonates and premature infants (see CONTRAINDICATIONS). Note that this list is not all-inclusive and includes only common medications that may interact with semaglutide. Ozempicshould be administered by a patient once weekly on the same day each week, at any time of the day, with or without meals. What should I know regarding pregnancy, nursing and administering Cyanocobalamin (Vit B-12) 1,000 Mcg/Ml Injection Solution to children or the elderly? In pediatric patients, especially, antihistamines in overdosage may cause hallucinations, convulsions, or death. This product is not a substitute for a proper diet. What are the effects of taking expired benadryl? However, in clinical trials, this did not appear to change the effects of other medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. How does Ozempic compare to other once-weekly glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapies? Cyanocobalamin is the most widely used form of vitamin B 12, and has hematopoietic activity apparently identical to that of the antianemia factor in purified liver extract. It doesn't need to be refrigerated. Store at 2 C to 8 C (Refrigerate. Repeat determinations of iron and folic acid may reveal a complicating illness that might inhibit the response of the marrow. Available in packages of ten (N 0071-4259-03).